The growth in the number and proportion of older adults in the United States has reached unprecedented levels, creating a number of issues for Baby Boomers, including a rise in chronic conditions, greater demand for pain relief, overuse of pharmaceuticals and high prescription expenditures. Combined with the looming physician shortage, the U.S. healthcare system faces the potential for longer waiting times and lower quality of medical care.

Seniors represent 13.7 percent of the United States population, about one in seven Americans.2 Almost 92 percent of older adults have at least one chronic condition, and 77 percent have at least two. Some type of disability, such as difficulty in hearing, vision, cognition and ambulation, was reported by 36 percent of adults aged 65 and over.

In the midst of these trends, Complementary and Alternative Medicine (CAM), the wide array of healthcare practices, products and therapies that are distinct from those used in conventional medicine, is expected to experience unprecedented popularity. CAM practices are diverse and include chiropractic, massage therapy, acupuncture, nutritional medicine, naturopathy, herbalism, Ayurveda, Reiki, laser therapy and electrotherapy.
CAM also includes a large and diverse group of orally or topically administered products such as herbal medicines, botanicals and probiotics that are widely marketed and readily available, often sold as dietary supplements.

CAM therapies emphasize the natural healing ability of the body and prevention versus the conventional approach of treating disease and its symptoms. A growing number of traditional healthcare professionals have begun to integrate CAM into their treatment programs for its proven benefits, including pain and injury prevention, post-surgical treatment and non-invasive pain relief. For instance, the Mayo Clinic has incorporated massage therapy into post-surgical treatment.
The Mayo Clinic has incorporated massage therapy into post-surgical treatment, and California now allows chiropractic services for reimbursement when they are provided in federally qualified health centers (FQHC) and rural health clinics (RHC) — further demonstrating the mainstream acceptance of chiropractic.

The purpose of CAM is to move patients toward complete wellness, helping them to discover and understand the hidden causes of health challenges, creating a customized and comprehensive treatment plan, and investing in healthy aging to achieve lower disability rates down the road.

PAIN MANAGEMENT IN AMERICA
Pain is the most frequent reason patients visit the emergency department (ED) — over 70 percent. A number of studies show that fewer than half of post-operative patients receive adequate pain relief, despite the fact that poor pain management puts patients at risk, creates needless suffering, and increases costs of care.

It is also well documented that certain populations, including seniors, bear the burden of chronic pain disproportionately. Given the high cost of pain in human lives, dollars, and social consequences, CAM presents an avenue for relieving pain across the healthcare continuum.

The goal of pain management is to improve a patient’s quality of life. Paradoxically, advances in medicine that have led to greater survival rates among patients with cancer, heart disease, HIV/AIDS, stroke, traumatic brain injury and many other diseases have increased the number of people living with chronic pain.

The physician shortage will aggravate the issue of pain management. Currently, there is a shortage of more than 13,000 physicians, with the expected shortfall to grow 10-fold within 12 years.

HOW CAM ADDRESSES ACCESS ISSUES
Licensed chiropractors, massage therapists, acupuncturists and naturopathic physicians continue to be sought after as accessible and cost-effective healthcare solutions. CAM providers are held to the same strict standards of quality as conventional providers including advanced education, licensure, credentialing, the delivery of evidence-based care, and accountability for outcomes.

CAM providers, especially chiropractors and naturopathic physicians, represent first-contact providers and maintain referral relationships with conventional medical providers when services beyond the CAM practice become necessary. Overall, the practice of CAM has risen dramatically in recent years. According to the National Institutes of Health, an estimated 18 million Americans receive massage therapy each year, while chiropractors treat more than 30 million people annually.

A National Institutes of Health study found that among insured patients with back pain, fibromyalgia, and menopause symptoms, those who use CAM have lower insurance expenditures than those who do not use CAM. The study noted that CAM therapies avoid high technology and offer inexpensive remedies. CAM providers in this study included chiropractors, licensed massage therapists, acupuncturists, and naturopathic physicians.

The results suggested that, because individuals with high disease burden typically drive the majority of claims expense, the potential for savings is much greater for CAM users. What’s more, the trend toward the integration of CAM into standard care will improve access to care for many Baby Boomers.

PAIN MANAGEMENT OPTIONSChiropractic: Chiropractic treatment of neck and back pain, which is common among aging Americans, provides more relief than over-the-counter drugs like aspirin and ibuprofen. In one
study, after 12 weeks of treatment more than half treated reported at least 75 percent reduction in pain compared with one-third in the drug group. A year later more than 50 percent of those treated with chiropractic reported significant decrease in pain. In contrast, the patients taking pain killers had upped their dosage during the same period.

Massage Therapy: Studies show that massage therapy increases endorphins and serotonin, chemicals that act as natural painkillers and mood regulators. Massage therapy also reduces levels of the stress hormone cortisol, and turns off genes associated with inflammation and its associated pain, which in turn relieves muscle soreness. Moderate to deep pressure massage can activate the vagus nerve which regulates heartbeat, helping seniors experience pain relief for a number of conditions. Studies also show that massage helps reduce anxiety, pain and nausea in cancer patients by 44 percent, and also raises the level of cancer-fighting white blood cells.

Acupuncture: Acupuncture has been shown to relieve a wide range of pain conditions that impact seniors, such as carpal tunnel syndrome, fibromyalgia, headache, low back pain, myofascial pain and osteoarthritis. One study found that during acupuncture trials for patients with chronic low back pain, only 15 percent of subjects who received genuine acupuncture treatment needed extra pain medication, compared with 34 percent who were receiving placebo treatments, and 59 percent receiving conventional therapy. Furthermore, long-term pain reduction was achieved more effectively in subjects who received either real or placebo acupuncture versus those who received conventional therapy.

KEY ISSUES IN ADDRESSING PAIN MANAGEMENT FOR AGING AMERICANSPopulation Boom
The population of Americans aged 65 years or older during the next 25 years is expected to reach about 72 million. By 2030, older adults will account for roughly 20 percent of the U.S. population.

During the past century, a major shift occurred in the leading causes of death for all age groups, including older adults, from infectious
diseases and acute illnesses to chronic diseases and degenerative illnesses. More than a quarter of all Americans and two out of every three older Americans have multiple chronic conditions, and treatment for this population accounts for 66 percent of the country’s healthcare budget.

The cost of providing healthcare for one person aged 65 or older is three to five times higher than the cost for someone younger than 65. Although the risk of developing chronic diseases increases as a person ages, the root causes of many of these diseases often begin early in life. Practicing healthy behaviors from an early age and getting recommended screenings can substantially reduce a person’s risk of developing chronic diseases and associated disabilities.

Overuse and abuse of pharmaceuticals
For decades, the most important tool in a health toolkit was the prescription pad, with an emphasis placed on treating an illness rather than focusing on prevention and treating the whole body. Hundreds of thousands of the nation’s seniors misuse prescription drugs, including painkillers, anxiety medications and other pharmaceuticals for treating a number of conditions from joint pain to depression.

Doctors are prescribing highly addictive drugs to older patients at record levels, according to a USA TODAY examination of government data. The impact,as measured in overdose deaths, ED visits and admissions to treatment programs, is considerable. Studies project that the number of seniors misusing pharmaceuticals will keep growing, fueled by the aging Baby Boomer population. Among the most common prescriptions given to older patients are opioid pain relievers and benzodiazepines, the psychoactive medications, such as Xanax and Valium, often used for anxiety. According to data from IMS Health, which tracks drug dispensing for the government, the 55 million opioid prescriptions written in 2013 for people 65 and over marked a 20 percent increase over five years — nearly double the growth rate of the senior population.

The average number of seniors dependent on prescription pain relievers in the past year reached an estimated 336,000, up from 132,000 a decade earlier, according to data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Annual ED visits by people 65 and over for pharmaceutical complications climbed more than 50 percent during that time, and the rate of overdose deaths among people 55 and older, regardless of drug type,
nearly tripled from 1999 to 2010, to 9.4 fatalities per 100,000 people, according to the Centers for Disease Control and Prevention.

The economic impact of medication-related problems in persons over the age of 65 is as much of an issue as Alzheimer’s disease, cancer, cardiovascular disease and diabetes. Medication-related problems are estimated to be one of the top five causes of death in that age group, and a major cause of confusion, depression, falls, disability and loss of independence.

Rising cost of pharmaceuticals/drugs
Fifty percent of seniors take eight or more prescriptions on average. Top contributors to the cost trend among Baby Boomers include diabetes (28.3 percent), rheumatological (14.6 percent), and asthma and chronic obstructive pulmonary disease (COPD) drugs (14.3 percent), according to the 2010 Medco Drug Trend Report. Medco also found that as many as 75 percent of insured Americans in the Baby Boomer group are currently taking at least one medication for a chronic condition, and more than half are regularly taking three or more drugs. A 30-day supply of six of the 11 name-brand drugs that Medicare beneficiaries use the most cost more than $250 each.

CAM: EXPLORING ALTERNATIVES
CAM’s growing popularity highlights a path for improving conventional medicine and mitigating the three-pronged challenge of cost, access and quality. Fortunately,U.S.medical schools are developing CAM course work, and managed care organizations are providing some coverage for CAM therapies. A study by Harvard Medical School researchers, looking at trends over the past half-century, indicates that CAM will play a role in the U.S. healthcare system for the foreseeable future.

The study examined trends in the use of 20 different CAMs, covering everything from acupuncture to yoga, among representative socio-demographic groups across the continental U.S.
The findings show that:

Most of CAM therapies have steadily increased in popularity since the 1960s

Of those respondents who had tried an alternative therapy, almost 50 percent were still
using it 11 to 20 years later

Most CAM therapies are used–at least in part–as preventative measures or as part of a regular fitness program

Demand for CAM is likely to grow.

HEALTHCARE WORKERS LEADING THE WAY IN THE CAM ADOPTION
Baby Boomers’ willingness to adopt innovative services is likely to hasten progress in patient- managed technology, such as mobile health, and reform in pain management approaches. The shift toward CAM will become exponential, especially given that many CAM approaches are no longer considered “alternative” for healthcare workers, the majority of whom use some form of CAM for themselves.

In fact, 76 percent of healthcare workers use CAM, compared to 63 percent of the general population. What’s more, healthcare providers, including doctors and nurses, were more than twice as likely to have used practitioner-based CAM, and nearly three times as likely to use self-treatment with CAM, during the prior year than support workers.

CONCLUSION
An increase in the number of chiropractors, massage therapists and acupuncturists has sparked an industry focused on providing high quality CAM equipment, supplies, life-enhancing products and the latest technology for consumers and businesses. Such medical developments and techniques are poised to change the face of healthcare.

At the same time, Baby Boomers are re-examining their priorities and taking better care of themselves, following basic health principles, such as exercising, eating whole foods, getting plenty of sleep, avoiding tobacco, sun exposure and stress, and increasingly turning to CAM as an important part of their overall healthcare. This fundamental behavioral shift will help to curb reliance on costly conventional medical care and improve overall pain management. To meet this coming upsurge in demand for real healthcare value, fully integrated CAM providers and CAM insurance benefits will play a critical role.

ScripHessco, providers of high quality chiropractic supplies and equipment, announces today its strategic relationship with two of the country’s leading doctors of chiropractic, Spencer H. Baron, D.C., DACBSP®, team chiropractor for the Miami Dolphins, and Alan K. Sokoloff, D.C., DACBSP®, owner and clinic director of the Yalich Clinic Performance and Rehabilitation Center and team chiropractor for the Baltimore Ravens.

“We look forward to working with Drs. Baron and Sokoloff to develop a broad array of mutually beneficial programs and advisory services that will provide industry trends and knowledge, clinical information, workflow insight, product reviews and evaluation to help chiropractors improve patient outcomes and grow their practices,” says Kray Kibler, CFO, ScripHessco.

ScripHessco is the leading supplier to the chiropractic profession, offering an unparalleled selection of supplies and equipment for a one-stop shopping experience, as well as value-added services that help chiropractors improve treatment and optimize patient health and wellness.

Dr. Baron, a committed leader of the healthcare community who has served several prestigious appointments for local, state and national groups, states, “I’m enthusiastic to work with ScripHessco because of its excellent client services and teamwork approach, and proud to play a role in helping doctors of chiropractic be more successful in their practices by giving them the latest tools and knowledge for providing the most advanced care, as well as useful product knowledge and business tips for practice enhancement.”

Dr. Sokoloff, now in his 27th year of practice and team chiropractor for the University of Maryland since 1991, adds, “I’m pleased to join ScripHessco’s mission to elevate the profession of chiropractic, promote its value for promoting wellness, and serve the professional needs of this growing industry.”

About ScripHesscoScripHessco, member of the Scrip Companies family, provides equipment and supplies to complementary and alternative medicine (CAM) professionals and offers the broadest selection of chiropractic products, including the largest variety of reconditioned adjusting tables in the world. ScripHessco offers exceptional customer service, promotes wellness initiatives and serves as an educational resource for the benefit of its customers and also is the only national company to offer regional sales representation. Visit www.scriphessco.com.

ScripHessco Teams up with the Professional Football Chiropractic Society

(February 11, Bolingbrook,IL) –ScripHessco announced today its partnership with the Professional Football Chiropractic Society (PFCS) as the 2014-2015 title sponsor. Scrip Hessco will also be the official distribution partner and table supplier to the PFCS.

In addition, ScripHessco and the PFCS will collaborate during the NFL Scouting Combine in Indianapolis in February to fulfill a need within the industry. Together, they will launch a new networking event called the “Chiropractic Combine” in which chiropractic students and doctors meet in a social setting to discuss trends in sports chiropractic, open chiropractic positions in sports and professional football, and available associate positions within the field.

“We hear from very qualified students seeking jobs and from top doctors in need of new associates as well as sports chiropractors looking to better use their skills,” stated Kyle Prusso, President of the PFCS and team chiropractor for the Oakland Raiders NFL football team. “The idea originated with one of our members, Alan Sokoloff of the Baltimore Ravens. The PFCS board and I all agreed that ScripHessco was a natural to join our team in bringing quality graduates and hiring doctors together during our PFCS Continuing Education Seminar because of their long history of supporting and giving back to the chiropractic community.”

“ScripHessco has quietly served the industry through foundations and associations for years,” added Frank Brady, Chairman of the PFCS and team chiropractor for the Philadelphia Eagles NFL football team. “We feel it’s important to partner with an industry leader that supports the cause of chiropractic, and ScripHessco is clearly the player we want on our team.”

“Through their work with world class athletes, NFL players, and educational seminars, the PFCS has made significant contributions to advance awareness of the importance and healing nature of chiropractic,” stated Kray Kibler, CEO of Scrip Companies, parent of ScripHessco. “We look forward to working together as a team and building relationships in support of this industry.”

Registrations are being taken now for the Continuing Education Seminar February 21-22 in Indianapolis, IN and for the Chiropractic Combine on Friday, February 21 at 6:00 pm at www.ProFootballChiros.com.

About ScripHessco:

ScripHessco, www.scriphessco.com, is the leading supplier to the chiropractic profession, offering an unparalleled selection of supplies and equipment for a one-stop shopping experience. ScripHessco has a long history of providing support to the chiropractic community through its contributions to the Foundation for Chiropractic Progress, various industry foundations and associations, and now through the Professional Football Chiropractic Society.

About the Professional Football Chiropractic Society:

Professional Football Chiropractic Society (PFCS), www.ProFootballChiros.com is an organization of chiropractors who provide the highest quality Chiropractic health care to the elite athletes of Professional Football. Our mission is to communicate and provide education. To initiate and continue a better understanding of Chiropractic for athletes, coaches, administrative and healthcare staff of our respective teams. It is our goal to enhance the health and performance of each and every individual athlete, so they may express their optimal health potential.

Join us at the Parker Seminars in Las Vegas – January 2014. If you are there stop by our booth 309 to hear about our new chiropractic supplies and equipment.

Parker Seminars in Las Vegas – January 2014

The World’s LARGEST Chiropractic Seminar is Heading to Las Vegas!

If there was ever a time to experience Parker Seminars, the world’s top chiropractic seminar series, that time is January 9-11 in Las Vegas, where practicing chiropractors, speakers, and coaches from around the world are meeting for our flagship event. It’s PARKER SEMINARS LAS VEGAS 2014, and it’s set to be our biggest, most extraordinary seminar yet!

At Scriphessco.com, chiropractors can find the products that they require, easily, conveniently, and affordably. Scrip Hessco’s massive inventory allows chiropractors to search for specific items, or browse for new and exciting options. The most successful chiropractors are the ones that are constantly evolving and taking necessary steps to keep business fresh and interesting for the patients, as well as for themselves.

For more than 40 years, Scrip Hessco has been the leading full-service distributor of supplies and equipment to the chiropractic industry. Rely on Scrip Hessco to help you serve your patients and grow your business with popular resale items.

Citrus II® Hospital Germicidal Deodorizing Cleaner is designed specifically as a general non-acid cleaner and disinfectant. In addition, this product deodorizes those areas which generally are hard to keep fresh smelling. This is a Bactericidal, Virucidal, Tuberculoidal, Fungicidal, Disinfectant and Cleaner.

Cleans, deodorizes, and disinfects surfaces, equipment, and non-critical instruments. A broad spectrum germicidal cleaner, effective as a bactericide, fungicide, and virucide, including Hepatitis B and C, HIV-1 (AIDS) and Tuberculosis, with excellent residual biocide action. It’s also effective against mold and mildew. Great for use in veterinarian offices and clinics, effective against Parvo Virus. EPA-registered, non-alcohol formula contains no toxic chemicals such as phenols or glutaraldehydes, and is tested safe for a variety of surfaces including vinyl and naugahyde. It’s non-acidic, non-corrosive, and non-staining. Citrus II® is ready-to-use so there’s no inconvenient mixing, dilution, or activation required as with concentrates. Refreshing citrus scent keeps the facility smelling clean and fresh.

Choosing the right chiropractic equipment for your office can be very confusing. What brands do I consider? What features do I need? Do certain options make sense? Should I buy new or used? The list can be endless.

An adjusting chiropractic table is the most important piece of equipment you will have in your office. It will be the main platform for the treatment of your patients. There are plenty of very good manufacturers of adjusting chiropractic tables on the market. Most make tables that fit a variety of techniques. Lloyd Table Company, Pivotal Health Solutions, Williams Healthcare, Hill Labs and Elite tables are a few of the major brands that currently make adjusting tables in a variety of models. So how do you choose what you need?

Step 1. Make a list of the features you want on the Chiropractic table.

A lot of this will be determined by the techniques you currently practice and would like to learn in the future. Some features to consider are:

Hylo – this feature takes a patient from a standing position to a flat position.

Elevation, which will electrically vary the height of the table in order to perform different techniques on the same table or enable to doctors of different heights to effectively use one table.

Drops (manual or automatic) – a section of the table that can be cocked and dropped when a thrust is applied to aid or enhance the adjustment.

Flexion/distraction (manual or automatic) for treatment of the low back. This feature allows the pelvic section of the table to flex downward and extend outward to aid or enhance the adjustment and to help stretch out the low back

Chest breakaway—the chest piece breaks away in order to help facilitate the treatment of pregnant or obese patients.

One feature that I always suggest is the elevation feature. First, the cost of this feature is currently diminished because you can take advantage of the Section 44 handicapped access tax credit. This allows for a 50 percent tax credit to be taken off the purchase price of the table that includes this option. In many cases, this makes the final cost of the table less than the same table in a stationary format would cost. Second, the elevation feature also allows for much flexibility. It allows for one table to be used by a variety of doctors. For example, a 5’ 10” doctor can treat a patient followed by a 6’ 4” doctor treating another patient by simply raising the height of the table to adjust to differing height of the doctor. In addition, you can perform a drop technique at the proper height, normally a lower height, and then increase the height to a higher height to perform a low-force technique or soft-tissue work. Elevation may be added or purchased on a variety of adjusting table models. It can be included on a drop table, a low-force technique table, a flexion/distraction table and so on.

A lot of this may be determined by your experience and suggestions from others—what tables you are used to using in clinic, the tables your teachers suggest, or the tables your associates like.

A major factor will also be budget. Adjusting tables will vary greatly in price—from a flat stationary table for under $500 to a Lloyd Ultimate table with virtually every possible feature available for more than $20,000.

Work on as many different tables as possible to find the features that best fit you. For example, drops will vary in speed and mechanics; some people will only want manual flexion and others will want the automatic feature.

The main thing to remember is that just because it works best for one doctor does not mean it will work best for you. Try not to purchase a table without working on it. Just because it has a look that you like does not mean it will operate in a manner that suits you. In addition, utilize the knowledge of the people you trust who have purchased and used the tables.

Step 3. Consider new versus used Chiropractic tables.

To buy a new or used Chiropractic table is probably the most asked question when shopping for a table. Again, this comes down to budget. If you are running a successful practice, have the funds or could use the tax write-offs, then new table is definitely the preference. If you are starting up a new practice, used is an option.

The problem when purchasing used table is you don’t ever really know how much time is left for practical use of the table. Tables have many different mechanical features, such as electric motors, hydraulics, mechanical mechanisms like drops. All of these things break and wear out, and they can be very expensive to fix, so many times the old adage “If it looks too good to be true, it probably is” often applies.

The best alternative when purchasing a used table is to purchase a refurbished table from a reputable dealer. A reputable dealer will purchase the used tables, strip them down and then rebuild them to your specifications; replace and update mechanics, electrical and hydraulics; and then paint, re-foam and recover in your desired materials. You will also receive some warranty on these tables. You can usually save 40 to 60 percent on a refurbished table over the purchase of a similar new table.

The idea of pricking your body with needles in order to relieve pain seems nothing if not counter intuitive, but thousands of acupuncture patients swear the treatments are effective in addressing pain of all kinds.

But how does it work? How much of the relief is due to the placebo effect — the mere perception that the needles are actually dulling pain — as opposed to a real biological change in the way nerves signal the brain to pain?

A new study lends support to the notion that acupuncture may actually modulate the brain’s perception of pain. In a study that used functional magnetic resonance imaging (fMRI) to track brain activity both before and during acupuncture, researchers led by Dr. Nina Theysohn at the University Hospital in Essen, Germany, and colleagues at University of Duisburg-Essen documented a specific pattern of brain activation during acupuncture that may represent an accessible pathway for addressing pain.

In the small trial, which involved 18 volunteers, each volunteer was placed in the fMRI scanner and then given a small electrical stimulus in the left ankle to generate pain. Acupuncture needles were then inserted at three places on the right side corresponding to regions known to modulate the ankle pain, and the fMRI was repeated.Comparing the brain scans before and after acupuncture, the scientists found that areas of the brain that were active during the pain stimulus were dampened during acupuncture, suggesting that the needles actually do cause a change in the way that the brain perceives and processes pain.

The chiropractic services at the Branch Health Clinics started in 2003, and treat approximately 300 patients per week, generating about 55 to 60 appointments per day at the three health clinics in the San Diego area, with one chiropractor per clinic.

All active duty service members are eligible for chiropractic care. Patients may receive referrals from their primary care doctor for the chiropractor. The chiropractic services fall under the physical therapy department. Patients are primarily seen by the chiropractor for back and neck pain.

“Many muscle and joint imbalances are due to a prior injury resulting in stiffness in joints or muscles,” said Cmdr. Michael D. Rosenthal, Department Head of Physical and Occupational Therapy at Naval Medical Center San Diego. “Our bodies do a very good job of compensating for those things so unless someone really works hard to get back to their pre-injury condition, patients will often times develop muscle or joint imbalance with tightness, weakness and/or stiffness.”